Even as the Capital Region's hospitals have consolidated into three major organizations, a push to bring services closer to the customer has triggered a construction boom in the cities and suburbs.

More than $1 billion has been spent since 2001 on the upgrades and new facilities.

Clifton Park has seen the completion of a new cancer treatment center and an urgent care center that's open around the clock. Another urgent care center is being expanded and a physicians' group plans to move into a new health center. Town Supervisor Phil Barrett estimates the town has $80 million worth of health-related construction completed or underway.

"This is a very good development for the residents of Clifton Park, who can access health care close to home," he said.

Ellis Medicine's urgent care center is available 24/7, and staffed with emergency room physicians, said Paul Milton, Ellis' president and CEO. "We went up to Clifton Park and listened to the community," he said.

Called the Medical Center of Clifton Park, the Ellis center represented a $20 million investment.

Not too far away, St. Peter's Health Partners is expanding its urgent care presence with a $7.5 million project at an existing facility on Route 146.

"Health care is getting much more customer-focused," said Dr. James K. Reed, president and CEO of St. Peter's Health Partners. For the patient, "It's a lot more convenient."

The cities also are seeing a construction surge as duplicate facilities are eliminated and existing buildings are expanded and improved.

Samaritan Hospital in Troy, now part of St. Peter's Health Partners, will see a new patient tower. A parking garage, meanwhile, is nearing completion. The Samaritan projects total about $100 million. Troy's other hospital, also part of St. Peter's, will no longer provide acute care. Instead, St. Mary's Hospital is becoming an ambulatory care center.

St. Peter's earlier spent $259 million on a major expansion of its hospital in Albany.

Ellis Medicine is spending $61 million on new emergency department facilities at Ellis Hospital, and invested $16 million on improvements to Bellevue Women's Center in Niskayuna. It turned Schenectady's other hospital, St. Clare's, into an ambulatory care center that also offers long-term nursing home care, and renamed it the McClellan Street Health Center.

Albany Medical Center, starting in 1994, has spent more than half a billion dollars on various projects in Albany's New Scotland Avenue corridor, including $360 million on a new patient pavilion. It is investing $55 million in the Park South neighborhood redevelopment — Tri City Rentals of Albany will invest another $55 million — to create new residential and retail space in an area bordering the medical campus, as well as a new medical office building.

Albany Med teamed up with Saratoga Hospital on an urgent care center in Malta that, like the Ellis center in Clifton Park, is open around the clock.

Physicians' practices also are in the midst of a building boom.

Community Care Physicians has opened new health care centers that include urgent care facilities in Delmar, Latham, Niskayuna and North Greenbush. It will be the main tenant in a $14.6 million medical office building that Columbia Development plans for Clifton Park.

The new facilities come as the number of hospital beds declines. Reed says patients who might have been admitted to a hospital 20 years ago now get taken care of in ambulatory care instead.

"With the Affordable Care Act, more people have health insurance and are seeking care," said Venditti. He said that setting up services closer to patients has been a long-term trend. Early on, however, there were challenges.

Venditti remembers that paper records and charts had to be moved back and forth between the hospital and offices in other communities.

"Fast forward to electronic health records," and records are available to offices from Glens Falls to Poughkeepsie, he said.

While hospital construction has typically been financed through bonds, philanthropy or the institution's own cash flow, many of the urgent care centers and medical offices are built by developers and then leased to the hospital organization.

"Most of our off-site locations, we prefer to lease rather than own," said Venditti. "It's not our core competency to be a developer, builder or landlord."

Columbia Development has played a role in the majority of the projects. Richard Rosen, partner and vice president, said Columbia has developed at least 21 medical buildings, with a total of slightly more than 1.5 million square feet of floor space or more than 34 acres, in the past 15 years, not including its work on hospitals' patient towers and related facilities.

The for-profit sector also is adding walk-in clinics to provide health care. CVS Health acquired MinuteClinic in 2006 and now has more than 900 in-store clinics offering care for common family illnesses, as well as screenings, wellness programs and vaccinations. CVS plans to grow that number to 1,500 by 2017, according to The New York Times. A spokesman said there are no immediate plans to add clinics in Capital Region stores, although some will open in western Massachusetts by the end of this year.

Walgreens, Rite Aid, Target and Walmart also have been adding in-store clinics, although none has any in New York state. CVS is acquiring Target's in-store pharmacy and clinic business for $1.9 billion, with the clinics to rebranded CVS/minuteclinic. Price Chopper has QuickCare walk-in clinics at its Market Bistro store in Latham and at its supermarket in Malta.

Hospital officials don't see the expansion winding down anytime soon.

"I think you will continue to see more development of different types of facilities," said Venditti of Albany Medical Center. "Delivery of health care is changing. The technology gets better. It is an exciting time for health care."